R92.2 ICD-10-CM Code: Inconclusive mammogram
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99) / Abnormal findings on diagnostic imaging and in function studies, without diagnosis (R90-R94)
R92.2
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceInconclusive mammogram
A mammogram result that is unclear or cannot definitively rule out breast cancer, requiring additional imaging or follow-up evaluation.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
N/A—
Not mapped
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
Official- Inconclusive mammogram NEC
- Inconclusive mammography NEC
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for R92.2 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for R92.2 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for R92.2 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for R92.2 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for R92.2 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for R92.2 in this effective period.
Buddy Documentation Tip
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is R92.2 an HCC code?
No. R92.2 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
Coder workflow notes
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This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
R92.2 is the ICD-10-CM diagnosis code for inconclusive mammogram. A mammogram result that is unclear or cannot definitively rule out breast cancer, requiring additional imaging or follow-up evaluation. R92.2 sits in the ICD-10-CM chapter for symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (r00-r99), within the section covering abnormal findings on diagnostic imaging and in function studies, without diagnosis (r90-r94).
R92.2 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Use this code when the mammogram findings are ambiguous and do not provide a clear diagnosis.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for R92.2 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code when the mammogram findings are ambiguous and do not provide a clear diagnosis
- •Often requires documentation of recommended follow-up imaging such as ultrasound or MRI